Medications for Bipolar Disorder

Bipolar disorder (BPD) is a lifelong mental health condition that causes dramatic, unhealthy mood swings. The “highs” are called mania or hypomania, and the “lows” are called depression. Treatment can help manage the mood swings that disrupt a person’s life.^1,2

Successful treatment involves a combination of prescription medicine, talk therapy, and lifestyle changes. The medicines that work best vary depending on the person. Factors that affect whether a drug will work include:^1,2

• The type of bipolar disorder they have
• Whether they are in a manic, depressed, or maintenance episode
• The severity of the episode

The most common medicines prescribed to treat BPD are mood stabilizers, antipsychotics, and, less often, antidepressants.¹

Mood stabilizers

Several prescription drugs can help stabilize mood swings. There are lots of brands and generic forms of these drugs. Some of them include:^1-5

• Lithium (Lithobid®, Eskalith®)
• Valproate, valproic acid, or divalproex (Depakote®, Depacon®, Depakene®, Stavzor®)
• Carbamazepine (Tegretol®, Carbatrol®, Equetro®, Epitol®)
• Lamotrigine (Lamictal®, Subvenite®)

Mood stabilizers may be used alone, or some can be combined with other bipolar medicines. Some are used for maintenance, while others are used to treat acute episodes of mania or depression. Some mood stabilizers are also used to control seizures. All medicine plans are individualized.^1,2

Antipsychotics

A class of drugs known as antipsychotics may be prescribed along with a mood stabilizer if someone has signs of severe mania. These signs may include delusions, hallucinations, or otherwise being disconnected from reality in some way (psychosis). Antipsychotics also may help people with mixed features. This means they have symptoms of mania and depression at the same time.^2,6-10

Examples of commonly prescribed antipsychotics include:^2,6-10

• Aripiprazole (Abilify®, Aristada®)
• Asenapine (Saphris®, Secuado®)
• Cariprazine (Vraylar®)
• Haloperidol (Haldol®)
• Quetiapine (Seroquel®)
• Risperidone (Risperdal®, Perseris®)

For bipolar depression, doctors may prescribe lurasidone (Latuda®) or a drug that combines olanzapine and fluoxetine (Symbyax®). Some people need to take antipsychotics for regular mood maintenance.^2,11

Antidepressants

Antidepressants alone usually are not recommended for people with BPD. This is because these drugs can trigger mania. Mood stabilizers are thought to be more effective for bipolar depression. But some people with severe depression may be prescribed an antidepressant and a mood stabilizer or antipsychotic for a short time.²

Sleep aids

Benzodiazepines, also called “benzos,” are drugs that slow down the brain and nervous system. These may be prescribed during a hospital stay along with a mood stabilizer and an antipsychotic. Benzodiazepines help reduce anxiety and agitation. They also can encourage sleep.^2,12

Other things to know

All drugs have potential side effects. Side effects can vary depending on the specific drug you are taking.

Most medicines used to treat BPD come in pill form. But a few can be injected or used as a patch.^1,2

People taking bipolar medicines require regular checkups. Doctors need to monitor how well they are controlling mood swings and whether they are causing serious side effects. All bipolar treatments work best when taken consistently for life. Mood stabilizers and antipsychotics work less well when only taken during severe episodes.^1,2

Before beginning treatment for BPD, tell your doctor about all your health conditions and any other drugs, vitamins, or supplements you take. This includes over-the-counter drugs.